益母草注射液促进剖宫产术后子宫复旧临床研究  

Clinical study on motherwort injection in promoting uterine involution after cesarean section

作　　者：万峰 王雅萍[2] 张霞[3] 严檬洁 高珊珊[3] 李晓燕 尹凤玲[4] 赵金侠[4] WAN Feng;WANG Ya-ping;ZHANG Xia;YAN Meng-jie;GAO Shan-shan;LI Xiao-yan;YIN Feng-ling;ZHAO Jin-xia(Basic Medical College,Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China;不详)

机构地区：[1]成都中医药大学基础医学院,四川成都610072 [2]南京市第一医院,江苏南京210012 [3]郑州大学第二附属医院,河南郑州450014 [4]徐州市中心医院/徐州医科大学徐州临床学院,江苏徐州221009

出　　处：《中国实用妇科与产科杂志》2022年第12期1235-1238,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：四川省科学技术厅支撑项目(2021YFQ0033);四川省科技成果转化示范项目(2018CC0108)。

摘　　要：目的 评价益母草注射液促进剖宫产术后子宫复旧的有效性和安全性,为临床合理用药提供参考。方法采用前瞻性、多中心、随机对照的研究方法,于2018年9月至2022年3月在3家医院纳入符合纳入排除标准的293例剖宫产产妇作为研究对象,随机分为观察组145例和对照组148例。对照组在产后前3d,每天静脉滴注缩宫素20U和二代头孢,连续3d;观察组在对照组基础上,在剖宫产术中肌肉注射益母草注射液2mL,术后2h肌肉注射2mL,之后肌肉注射2mL/次,1次/12h,连续5d。两组患者出院后,均口服产妇安颗粒或产复康颗粒,连续7d。以两组血性恶露持续时间、子宫体积、子宫内膜厚度和血流、凝血功能、炎性指标(IL-6、CRP)及合并使用其他止血类药物情况作为有效性指标。以不良反应、实验室检查(血常规、心电图)结果作为安全性指标。结果 与对照组相比,观察组可有效缩短血性恶露持续时间(P<0.05);缩小用药5d后和产后42~47d子宫体积(P<0.05);降低用药5d后子宫内膜厚度(P<0.05);增加产后42~47d子宫内膜厚度(P<0.05);提高用药5d后子宫内膜和内膜下血流指数(FI)、血管化血流指数(VFI)(P<0.05)及子宫内膜下血管化指数(VI)(P<0.05);升高凝血酶时间(TT)(P<0.05),降低纤维蛋白原(FIB)(P<0.05);降低炎性指标C反应蛋白(CRP)和白介素-6(IL-6)(P<0.05)。两组均未合并使用止血类药物,未见不良反应,心电图、血常规未见异常。结论 益母草注射液可促进剖宫产术后子宫复旧,其机制可能与改善炎性指标、子宫内膜及内膜下血流变化、凝血功能等有关,疗效明显,安全性佳,值得临床推广。Objective To evaluate the efficacy and safety of motherwort injection in promoting uterine involution after cesarean section,and to provide reference for clinical rational drug use.Methods This was a prospective,multicenter,randomized controlled study.A total of 293 women receiving cesarean section were finally selected for the study,who met inclusion and exclusion criteria,from September 2018 to March 2022 from 3 hospitals.They were randomly divided into experimental group and control group,with 145 cases in experimental group and 148 cases in control group.The control group received oxytocin 20U and cephalosporin intravenously every day for the first 3 days after delivery for 3consecutive days.On the basis of this,the experimental group received intramuscular injection of motherwort injection2mL during cesarean section,2mL intramuscularly 2h after operation,and then 2mL/time,once/12h,for 5 consecutive days.The patients in both groups were orally took Chanfuan Granules or Chanfukang Granules for 7 consecutive days after being discharged from hospital.The duration of bloody lochia,the difference in uterine volume,the difference in endometrial thickness and blood flow,the difference in coagulation function,the difference in inflammatory indexes(IL-6,CRP),and the combined use of other hemostatic drugs of the two groups were used as efficacy indicators.Adverse reactions and laboratory tests(blood routine,electrocardiogram)were used as safety indicators.Results Compared with the control group, the experimental group could effectively shorten the duration of bloody lochia(P<0.05),reduce the uterine volume at 5 days postpartum and 42-47 days postpartum(P<0.05),reduce the endometrial thickness at 5 days postpartum(P<0.05),increase endometrial thickness at 42-47 days postpartum(P<0.05),increase endometrial and subendometrial FI,VFI(P<0.05),and subendometrial VI(P<0.05)at 5 days postpartum,increase blood coagulation function TT(P<0.05),decrease FIB(P<0.05)and decrease inflammatory indexes CRP and IL-6(P<0.05).No hemostati

关 键 词：益母草注射液 剖宫产 子宫复旧 多中心 随机对照 

分 类 号：R719.8[医药卫生—妇产科学]